Immediate reocclusion of the infrapopliteal segment after thrombolysis in acute ischemia of the lower limb of the thrombotic nature

: Early reocclusion of below knee segment after fibrinolytic therapy is mainly due to thrombo-embolism, coagulopathy or to the arterial wall condition. 42 patients facing acute lower limb ischaemia because of iliofemoral thrombosis (prosthesis 19, native artery 23) underwent locoregional thrombolysis. UK was given in 33 cases while the others received rt-PA. The early reocclusion after fibrinolysis leads to a serious worsening in these patients; thrombosis in distal vessels and in microvasculature make any surgical approach unserviceable. Major amputation was required in 3 cases. We believe that fibrinolytic treatment has taken on great importance in making accurate diagnosing of thromboembolism and, once restored patency of distal vessels, allows to perform revascularization procedures.